Question 1

What is the large,fan-shaped muscle that covers the anterior chest from the sternum to the proximal end of the humerus and acts on the joint of the shoulder to flex,adduct,and rotate?

Accepted Answer

The Pectoralis major is the large, fan-shaped muscle that spans from the sternum to the proximal end of the humerus, playing a key role in flexing, adducting, and rotating the shoulder joint.

Question 2

The patient has been diagnosed as having gouty arthritis.The patient asks the nurse to explain the cause of the inflammation of the great toe.What is the most appropriate nursing response?

Accepted Answer

Gouty arthritis is caused by the accumulation of uric acid crystals in the joints, which leads to inflammation. These crystals are referred to as tophi, making option B the correct explanation for the cause of inflammation in gouty arthritis.

Question 3

Which patient statement indicates the need for additional teaching for a patient with rheumatoid arthritis who is taking meloxicam (Mobic)?

Accepted Answer

Meloxicam (Mobic) is an NSAID, and concurrent use with aspirin can increase the risk of gastrointestinal bleeding. Patients should be educated about the potential risks of taking these medications together.

Question 4

The nurse instructs the patient who is to have a unicompartmental knee replacement that a major advantage of this partial knee replacement is that:

Accepted Answer

Unicompartmental knee replacement, also known as partial knee replacement, allows for a quicker recovery time compared to total knee replacement. Patients can often start walking within hours after the surgery, which is a significant advantage of this procedure.

Question 5

What is the first priority nursing intervention for an impending fat embolism?

Accepted Answer

Administering oxygen is the first priority in the case of an impending fat embolism because it addresses the critical respiratory distress that can occur due to the embolism blocking blood flow in the lungs. This intervention helps ensure the patient receives adequate oxygenation, which is crucial for survival and preventing further complications.

Question 6

A patient has been casted to stabilize a fracture of the right radius and ulna.The nurse assesses a capillary refill of 5 seconds and cold fingers of the right hand.Which initial intervention should the nurse deploy?

Accepted Answer

Elevating the hand to heart level can help improve circulation and reduce swelling, potentially improving capillary refill time and warmth in the fingers.

Question 7

Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease?

Accepted Answer

Leafy green vegetables are rich in calcium and vitamin K, both of which are important for bone health and can help slow the progression of osteoporosis.

Question 8

A patient,age 68,has suffered an intertrochanteric fracture of the right hip.Before surgery,to provide support and comfort,an immobilizing device of a ______ is applied.

Accepted Answer

Buck traction is commonly used for immobilizing and providing comfort to patients with hip fractures before surgery.

Question 9

Which finding would delay a computed tomography (CT)scan?

Accepted Answer

The answer of Which finding would delay a computed tomography...

Question 10

What should the nurse instruct the patient before a magnetic resonance imaging (MRI)procedure?

Accepted Answer

Metal objects can interfere with the magnetic field of the MRI machine and pose safety risks, so patients are instructed to remove all metal items before the procedure.

Question 11

When a patient recovering from a fractured tibia asks what callus formation is,the nurse tells her it is:

Accepted Answer

Callus formation is a crucial phase of bone healing where new bone starts to form around the fracture site, bridging the gap between broken bone ends and stabilizing the fracture for further healing processes.

Question 12

A patient had an open reduction with internal fixation (ORIF)for a compound fracture of the left tibia and has been placed in a long leg cast.The assessments by the nurse are: left foot warm/pink,pedal pulse weaker than right,capillary refill 3 seconds,and small 1 cm area of blood on cast.What should the nurse do?

Accepted Answer

The assessments indicate that the patient's left foot is warm and pink with a capillary refill of 3 seconds, which are within normal limits after such a procedure. A small 1 cm area of blood on the cast can be expected after an ORIF procedure. The slightly weaker pedal pulse could be due to the surgery or the cast, but there are no immediate signs of compartment syndrome or significant hemorrhage.

Question 13

What should the nurse include in the teaching plan for a patient who is taking alendronate (Fosamax)?

Accepted Answer

Alendronate (Fosamax) should be taken first thing in the morning with a full glass of water, at least 30 minutes before eating, drinking, or taking any other medication to ensure adequate absorption and to reduce the risk of esophageal irritation.

Question 14

When the patient with rheumatoid arthritis complains about the daily exercise,the nurse encouragingly reminds the patient that exercises:

Accepted Answer

Exercise helps maintain joint flexibility and prevents stiffness, which is crucial for patients with rheumatoid arthritis.

Question 15

What should the nurse include in the plan of care for a patient following a myelogram?

Accepted Answer

Positioning the patient in a semi-Fowler's position helps reduce the risk of a postmyelogram headache by preventing cerebrospinal fluid leakage.

Question 16

Forty-eight hours after a patient sustained a fractured femur in a car accident,the nurse assessed a pulse of 110,respirations at 25,and labored crackles in both lung fields.The nurse immediately reports to the charge nurse the probability of a(n):

Accepted Answer

The symptoms described, such as tachycardia (pulse of 110), tachypnea (respirations at 25), and labored crackles in both lung fields occurring 48 hours after a femur fracture, are indicative of a fat embolism. Fat embolisms can occur when fat globules are released into the bloodstream, often after long bone fractures, and can cause serious respiratory distress.

Question 17

The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate indicates the presence of:

Accepted Answer

An elevated erythrocyte sedimentation rate (ESR) is a common indicator of increased inflammatory activity in the body, which is characteristic of conditions like rheumatoid arthritis. It does not directly measure immunoglobulin M, abnormal serum proteins, or C-reactive protein, although these may also be elevated in inflammatory conditions.

Question 18

What is the movement of an extremity away from the midline of the body called?

Accepted Answer

Abduction is the movement of a limb or other part away from the midline of the body or from another part.

Question 19

The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours.The nurse understands that the correct nursing intervention is to keep the legs:

Accepted Answer

Keeping the legs abducted (slightly apart) is crucial after a hip replacement to prevent dislocation of the new hip prosthesis. This position maintains the stability of the hip joint.

Question 20

A patient who has had a right below the knee amputation continues to complain of unpleasant sensation in the right foot.What can the nurse explain about this "phantom pain"?

Accepted Answer

Phantom pain occurs because the nerve endings at the site of the amputation continue to send pain signals to the brain, which makes the brain think the limb is still there. This is why patients experience sensations, including pain, in the limb that has been amputated.

Quiz 44: Care of the Patient With a Musculoskeletal Disorder